Minority Health

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Just over half (53 percent) of all U.S. patients treated for high blood pressure (hypertension) have their blood pressure under control. The rates of blood pressure control are significantly lower among non-Hispanic black and Latino patients being treated for hypertension—less than 45 percent of these patients have their blood pressure controlled. They generally understand and agree that certain foods and food additives play an important role in causing hypertension, but they also find clinician-recommended diets expensive, an unwelcome departure from traditional and preferred diets, and socially isolating.

These attitudes were revealed during discussions that took place in focus groups involving 88 black and Latino patients with hypertension. Findings from this study suggest the importance of culturally sensitive approaches to dietary improvements, according to Carol R. Horowitz, M.D., M.P.H., of Mount Sinai School of Medicine. Dr. Horowitz and her colleagues conducted nine focus groups involving blacks (four groups) and Latinos (five groups) treated at hospitals serving East and Central Harlem. These are poor neighborhoods that have high rates of obesity and mortality.

Focus group participants acknowledged that salt, pork, preservatives, additives, and overeating contributed to hypertension. They also agreed that dietary changes such as avoiding fat, pork, Chinese food, alcohol, and large quantities of foods, as well as eating more garlic, fruits, and vegetables and drinking more water can reduce blood pressure. However, they were discouraged that dietary changes might not eliminate the need for medications, and they often felt the perceived sacrifice in quality of life was not worth it.

Participants also noted that it was expensive to cook differently for themselves than they did for other family members, and it was difficult to forego traditional and preferred foods. The researchers recommend that clinicians who ask hypertensive patients to change their diet should also ask about patient-centered barriers to healthy diets and be sensitive to the cultural, economic, and social realities of their patients. This study was supported in part by the Agency for Healthcare Research and Quality (HS10859).

See "How do urban African Americans and Latinos view the influence of diet on hypertension?" by Dr. Horowitz, Leah Tuzzio, M.P.H., Mary Rojas, Ph.D., and others in the Journal of Health Care for the Poor and Underserved 15, pp. 631-644, 2004.